A retrospective analysis comparing mandibular fibula reconstruction by transoral versus submandibular approach
10.13591/j.cnki.kqyx.2025.05.006
- VernacularTitle:经口入路与经下颌下入路行下颌骨腓骨重建的回顾性分析
- Author:
Fan XU
1
;
Dongqing MIAO
;
Yuli WANG
;
Yifeng BIAN
;
Na XIAO
;
Yifei DU
;
Xu DING
Author Information
1. 南京医科大学附属口腔医院口腔颌面外科,江苏南京(210029);口腔疾病研究与防治国家级重点实验室培育建设点,江苏南京(210029);江苏省口腔转化医学工程研究中心,江苏南京(210029)
- Publication Type:Journal Article
- Keywords:
free fibula flap;
mandibular reconstruction;
surgical approach
- From:
STOMATOLOGY
2025;45(5):355-359,366
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibu-lar segmental resection and reconstruction with free fibula flaps(FFFs).Methods Patients who underwent mandibular segmental re-section and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed.All cases were divided into transoral approach and submandibular approach groups.Clinical characteristics of the patients were recorded including age,gender,follow-up time,pathologi-cal diagnosis,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,James Brown classification of mandibular defect and number of fibular segments.The perioperative indexes,such as average operation time,average bleeding vol-ume,average blood transfusion volume,average drainage volume,average hospitalization time and postoperative complications such as malocclusion,fistula,infection,flap failure,and restriction of mouth opening were compared between the two groups.The University of Washington Quality of Life Questionnaire was used to investigate the appearance,function of swallow and speech more than 6-month postoperatively.Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral ap-proach group than in the submandibular approach group(P=0.013 9,P=0.001 9).The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37)vs.(67.19±13.64)(P＜0.000 1).The differ-ences between the two groups in other variables were not statistically significant.Conclusion Cases of transoral approach had signifi-cantly better aesthetic outcomes compared with those of submandibular approach.
